The superiority of Epstein‐Barr virus DNA in plasma over in peripheral blood mononuclear cells for monitoring EBV‐positive NK‐cell lymphoproliferative diseases
The superiority of Epstein‐Barr virus DNA in plasma over in peripheral blood mononuclear cells for monitoring EBV‐positive NK‐cell lymphoproliferative diseases
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DOI：
10.1002/hon.2998
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发表时间：
2022-04
影响因子：
3.3
通讯作者：
M. Zheng;Yuhan Bao;Jiachen Wang;Yaxian Ma;Yang Yang-Yang;Peiling Zhang;Liting Chen;Kai Zheng;Jianfeng Zhou
中科院分区：
文献类型：
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作者：
M. Zheng;Yuhan Bao;Jiachen Wang;Yaxian Ma;Yang Yang-Yang;Peiling Zhang;Liting Chen;Kai Zheng;Jianfeng Zhou
爱泼斯坦-巴尔病毒（EBV）是一种普遍存在的病毒，可感染NK细胞，导致NK细胞型EBV阳性淋巴细胞增生性疾病（EBV-NK-LPD）。我们回顾性分析了202例EBV-NK-LPD（包括64例CAEBV-NK、27例侵袭性自然杀伤细胞白血病（ANKL）和111例结节性NK/T细胞淋巴瘤（ENKTL））患者EBV DNA拷贝实验室检测结果与临床特征之间的关系。在CAEBV-NK队列中，血浆或PBMCs中的EBV DNA载量在活动状态和非活动状态之间存在显着差异。应用受试者工作特征曲线（ROC）评价EBV-DNA拷贝数诊断的准确性。在比较曲线下面积后，血浆中的EBV DNA载量在区分疾病活化方面比PBMC中具有显著更高的准确性。因此，我们建议将CAEBV-NK诊断标准重新定义为血浆中EBV DNA拷贝数增加（超过7.1 × 102拷贝/ml），而不是外周血中。在ANKL和ENKTL队列中，接受有效治疗的患者血浆和PBMC中的EBV DNA拷贝数显著低于治疗无效的患者。显著和一致的下降表明血浆中的EBV DNA载量是监测EBV-NK-LPD治疗反应的更敏感的生物标志物。噬血细胞性淋巴组织细胞增生症（HLH）可继发于EBV-NK-LPD，大多与预后不良相关，因此我们试图通过监测EBV DNA拷贝来估计HLH的组合。在比较EBVDNA拷贝数的受试者工作特征曲线时，血浆EBVDNA载量具有较高的诊断准确性。当拷贝数超过4.16 × 103拷贝/ml时，可能提示与HLH结合。
Epstein‐Barr virus (EBV), characterized as an omnipresent virus, has been found able to infect NK cells and leads to NK‐cell type EBV‐positive lymphoproliferative diseases (EBV‐NK‐LPDs). We retrospective analyzed 202 EBV‐NK‐LPDs (including 64 CAEBV‐NK, 27 aggressive natural killer‐cell leukemia (ANKL), and 111 extranodal NK/T‐cell lymphoma (ENKTL)) patients' relationships between EBV DNA copies laboratory test results and clinical features. In CAEBV‐NK cohort, EBV DNA loads in either plasma or PBMCs had significant differences between the active state and the inactive state. Receiver operating characteristic curves were used to measure the diagnosis accuracy of EBV DNA copies. After comparing the area under the curve, EBV DNA loads in plasma had significantly higher accuracy in distinguishing disease activation than in PBMCs. Therefore, we propose redefining CAEBV‐NK diagnosis criteria as increased EBV DNA copies in plasma (over 7.1 × 102 copies/ml) instead of in peripheral blood. In ANKL and ENKTL cohorts, patients who received effective therapy had significantly lower EBV DNA copies in plasma & PBMCs than in those with ineffective therapy. The significant and consistent decline indicated EBV DNA loads in plasma being a more sensitive biomarker in monitoring EBV‐NK‐LPDs therapy responses. Hemophagocytic lymphohistiocytosis (HLH) can occur secondary to EBV‐NK‐LPDs, mostly associated with a poor prognosis, so we try to estimate the combination of HLH by monitoring EBV DNA copies. When comparing the Receiver operating characteristic curves of EBV DNA copies, EBV DNA loads in plasma had higher diagnosis accuracy. When the copies level over 4.16 × 103 copies/ml, it might indicate combining with HLH.